Drug IndexUplizna (Inebilizumab)
Billing
Code: J1823
Description: Inj. inebilizumab-cdon, 1 mg
Unit: 1 MG
Payment: $483.838
Pay quarter: Q3 2024
Covered in Part D: No
Drug Cost
Calculate drug cost and reimbursement
Total WAC:
N/ATotal Reimbursement:
N/A(ASP: N/A, Margin: N/A)
.
.# Units to bill:
N/ABillable NDCs
72677-0551-01
UPLIZNA (Viela Bio, Inc.)
3 VIAL, SINGLE-DOSE in 1 CARTON (72677-551-01) / 10 mL in 1 VIAL, SINGLE-DOSE (72677-551-03)
75987-0150-03
UPLIZNA (Horizon Therapeutics USA, Inc.)
3 VIAL, SINGLE-DOSE in 1 CARTON (75987-150-03) / 10 mL in 1 VIAL, SINGLE-DOSE (75987-150-01)
Prior Authorization
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